| NPI | 1083477103 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIRACLE A DOUGLAS Owner/Provider 470-710-9221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist Pediatrics |
| Additional Taxonomies | 2080P0006X Pediatrics Developmental - Behavioral Pediatrics |
| 224Z00000X Occupational Therapy Assistant | |
| 224ZF0002X Occupational Therapy Assistant Feeding, Eating & Swallowing | |
| 225200000X Physical Therapy Assistant | |
| 225A00000X Music Therapist | |
| 225XF0002X Occupational Therapist Feeding, Eating & Swallowing | |
| 225XP0200X Occupational Therapist Pediatrics | |
| 235Z00000X Speech-Language Pathologist | |
| Enumeration Date | 2024-02-01 |
| Last Update Date | 2024-02-01 |